Venture Pacific Insurance Services, Inc. specializes in commercial insurance Commercial Insurance Quote

 

Security Operations Group

Sample Coverage

Online Quote - Security Guard General Liability Insurance

Online Quote - Security Guard Workman's Compensation Insurance

 

Security Guard Workmans Compensation Insurance


General Company Information:
Name
Address
City
State
Zip
Contact
Telephone (ex. 310-555-5555)
Fax (ex. 310-555-5555)
Federal ID #
Business Form
Additional Locations
Operations in Other States
Where is Audit to be made
Audit Contact
How long in the Security Industry
How many years under this name
If in business less than 3 years give owners prior experience
Total number of employees
Full-Time
Part-Time
Total number of guard hours billed to clients
Armed
Unarmed
Average length of employment
Average hourly wage 
Number of dogs
With Handler? Yes  No
Type of Assignments using dogs
Any emergency response Yes  No
Is applicant involved in any other type of operations
List all clients to whom you assign armed personnel and their duties.
Training & Operations
Training program consists of:

Written Manual
On Job
CPR
Powers of Arrest
Report Writing
Fire Arms
Other, Please explain   
Pre-employment screening includes:

Prior employment check
Drug Screening
Fingerprint
Driving record
Criminal Background
Psychological Test
FBI check
Other, Please explain   
Do you have a formal safety program in force? Please explain.
Does applicant subcontract work to others? Yes  No
If so, are certificates of insurance required from the subcontractors? Yes  No
Does applicant own or use airplanes in business? Yes  No
Does applicant conduct any operations on dockside or aboard ships? Yes  No
Does applicant conduct any operations including railroads? Yes  No
Does applicant own or use autos in the business? Yes  No
Number of vehicles
Does applicant use golf carts in business? Yes  No
How are they used in business?
Do you work bars or other establishments serving liquor? Yes  No
Insurance Policy Information:
Proposed effective date from (ex. 01/01/01) to (ex. 01/01/01)
Current Policy Guard rate
Current Experience Mod Rate
Policy Period; Name of Carrier; Policy #; Estimated Premium
Has there been any name changes in the past 3 years? Yes  No
Has any insurance carrier cancelled or refused to renew your insurance? Yes  No
General Liability Carrier: Effective Date: (ex. 01/01/01)
Commercial Auto Carrier: Effective Date: (ex. 01/01/01) # Vehicles
List estimated annual payroll and receipts for upcoming year separately by category:
Unarmed Payroll Armed Payroll Receipts
Airports $ $ $
Banks or Office Bldgs $ $ $
Bodyguards $ $ $
Construction Sites $ $ $
Fast Foods $ $ $
Government Contracts $ $ $
Hotels/Motels $ $ $
Industrial/Mfg $ $ $
Institutions $ $ $
Liquor Establishments $ $ $
Patrol Cars $ $ $
Retail Shops $ $ $
Special Events $ $ $
*Other 1 $ $ $
*Other 2 $ $ $
*Other 3 $ $ $
*Other 4 $ $ $
Alarm Installation $ $ $
Clerical $ $ $
Executive Payroll $ $ $
*Please specify types of contracts labeled as other in box provided
List current & past two (2) years insurance policy information:

Policy Year  Insurance Co. name Policy Number Premium
What is your current policy's inception date? 
(ex. 1/01/01)
Have you ever been cancelled or non-renewed by an insurance company? Yes  No
Do you have any knowledge concerning any incidents that have occurred prior to the date of this application that may give rise to a future claim? Yes  No
If so, what?
If you would like to give our company permission to order loss history on your behalf (Past Policy Information must be completed) check yes below. If not you will need to send us 3 years currently valued loss history. Yes  No
Notice to applicants: This application must be completed in full as the quote will be based soley on the information provided. Any person who knowingly and with intent to defraud any insurance company or other person, files an application for insurance containing any false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime. By clicking "Submit", the applicant warrants that to their best knowledge all information given is true and accurate.